Causes

Bacteria grow on your teeth and create a filmy coating called plaque. A build up of this plaque causes an inflammation of the gum tissue, known as
gingivitis
. If gingivitis is left untreated, the plaque can extend under the gum line can create pockets around the teeth. Bacteria can collect in these pockets and cause regular inflammation and destruction known as periodontitis. Over time, this chronic inflammation and bacteria cause destruction of gum tissue, ligaments, and bones that hold your teeth in place.

Symptoms

Periodontitis normally occurs without symptoms. In those that have symptoms, periodontitis may cause:

Red, swollen, tender, or bleeding gums

Receding gums that may expose the root of your teeth

Loose teeth or teeth that fall out

Persistent bad breath

Presence of pus between your teeth

Change in the way your teeth fit together when you bite down

Swelling of face and jaw

Weight loss in elderly

Diagnosis

Your dentist will ask about your symptoms and medical history. A complete oral exam will be done. Periodontal disease can be diagnosed during an oral exam. Your dentist may do x-rays to determine how much damage has been done.

Treatment

The goal of treatment is to stop the bacterial invasion. Further course of treatment depends on the severity and progression of the periodontitis.

Talk to your dentist about the best treatment plan for you. Options include:

Deep Cleaning

A cleaning procedure called scaling and root planing is done first. These will remove excess build-up above and below the gum line, and along the tooth root where bacteria thrive. In some cases, lasers can be used to remove plaque.

Medications

Your dentist may recommend antibiotics to treat any bacterial infection. Antibiotics may be given as:

Oral tablets

Topical mouthwash

Beads that are placed into the infected gum pockets

Surgery

You may need surgery if your periodontitis doesn’t improve with deep cleaning or antibiotic treatment. Surgery may be also necessary to repair damaged gum tissues and bones. Surgical procedures include:

Flap surgery
—Sections of gum tissue are opened to access the root of the tooth for deep cleaning. The gum tissue is reshaped and put back into position.

Bone and tissue graft—Tissue from another part of your body is used as a base to promote regrowth of healthy gum, bone, or connective tissue.

Enamel matrix application—A special gel is applied to the tooth root to stimulate growth of healthy bone and tissue.

Dental implants
—An artificial tooth is placed in the jaw to hold a replacement tooth or bridge.

Prevention

To help reduce your chance of periodontitis:

Brush your teeth and tongue with fluoride toothpaste at least 2 times per day

Use a soft-bristled toothbrush or a powered toothbrush if advised by your dentist

Floss your teeth 1 time per day

Use a mouthwash after brushing and flossing your teeth

If you smoke or chew tobacco, talk to your doctor or dentist about how you can successfully quit

CANADIAN RESOURCES

References

Periodontal (gum) disease: Cause, symptoms, and treatment. National Institute of Dental and Craniofacial Research website. Available at: http://www.nidcr.nih.gov/OralHealth/Topics/GumDiseases/PeriodontalGumDisease.htm. Updated August 2012. Accessed November 6, 2013.

Revision Information

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.